short and insightful writing about a long and complex history

Guest Post: Jonathon Erlen’s Dissertation Abstracts (Fall 2014)

Editor’s Note: Readers of Social History of Alcohol and Drugs, the Alcohol and Drugs History Society’s journal, are aware of Jonathon Erlen’s ongoing bibliography of recent dissertations related to alcohol, tobacco, and other drugs. Until recently, Dr. Erlen, the History of Medicine Librarian at the University of Pittsburgh, curated and published his dissertation lists in the print edition of the journal. Last August, the Alcohol and Drugs History Society moved the publication of Erlen’s bibliography to the blog. Below, we highlight a few of the most intriguing entries and provide links to pdfs of Erlen’s selections from the ProQuest index. These entries were harvested from ProQuest’s database in the fall of 2014.

Sinners, Saints and Sophists: Marijuana Discourse and Policy in the United States, 1970-2010

Author: Malizia, Stefan

Department: Sociology

Institution: University of California at Irvine

Advisor: Frank, David John; Committee: Snow, David A.; Seron, Carroll

Abstract:

I study the evolution of public discourse and policy surrounding the use of marijuana in the United States between 1970 and 2010, focusing on the interactions of activists, public officials, and broader cultural and political contexts involved in social change. My goal is to explain the continuities and breaks between earlier debates on the decriminalization of recreational uses of marijuana, and more recent debates on the legalization of medical marijuana. I gather data primarily from a sample of articles from two prominent U.S. newspapers, collected for a content analysis of public discourse; and also from several archival sources of statistics, collected to model state-level passages of medical marijuana laws. My findings suggest a democratization of the discourse over time, such that actors excluded from decriminalization debates as deviants are able to `come to voice’ as credible authorities in medicalization debates, transforming public perceptions of marijuana and influencing the passage of liberalized state- level marijuana laws. More broadly, my findings suggest a greater role played by cultural contexts than is currently afforded by dominant theories of movements and social change.

Risk Factors for Injection versus Non-Injection Drug Use Among Men in Kermanshah City, Iran in 2005: An Observational Study

Background: Iran is one of the countries with the highest rate of opioid and heroin consumption in the world. Injection drug use (IDU) is a relatively new phenomenon in Iran, where opium smoking was previously more prevalent. This study aims to identify risk factors that differentiate drug users who become injectors from those who do not. Injection is associated with increased risk for HIV and hepatitis C virus (HCV), drug dependence, overdose, and other blood borne diseases. The aim of this study is to identify personal and social characteristics associated with injection among a sample of male drug users seeking drug treatment in Kermanshah, Iran. Methods: This observational study compared IDUs and non-IDUs in a sample of 948 males who sought addiction treatment at a methadone clinic in western Iran between February 1, 2004 and August 31, 2005. Logistic regression was employed to assess the association of the independent risk factors associated with IDUs compared to non-IDUs in this population. Results: The study population included 177 injection drug users (IDUs) (18.67%), and 771 non-IDUs. The unadjusted odds ratio indicated that drug users with the following characteristics were more likely to be IDUs: 1.) initiated drug use at a younger age; 2.) were born or lived in an urban area; 3.) obtained more education; 4.) were unemployed; 5.) were single 6.) and/or had no children;7.) started smoking before the age of 20; 8) had one blood relative drug user; 9.) used drugs four times or more per day; 10) ceased drug use while in prison; or 11.) began with or used other drugs like buprenorphine, heroin, or marijuana. The logistic regression analysis revealed that the following four risk factors out of aforementioned 11 variables remained associated with IDU in this sample:1) younger age, 2) buprenorphine use (an opioid partial agonist which can be used as a substantial therapy for opioid users), 3) using drugs four times or more per day, and 4). history of drug use cessation in prison. The impact of these factors differed based on the initiation of drug use before or after 2000. Subjects that began using drugs prior to 2000 (before the ban on poppy in neighboring Afghanistan) faced different environmental risk factors for injection. Among subjects who began using drugs after 2000, drug users who were more educated were at greater risk for injection as compared to less educated drug users, while among those who began using drugs before the year 2000, education level did not have an impact on injection. Conversely, being forced to quit drugs in prison or in mandatory governmental camps was a risk factor for injection. This is because during their time in prison, people had less access to substantial therapy and harm reduction services to relieve withdrawal symptoms. This held for subjects who began using drugs prior to the year 2000, but not those who began using after 2000. Conclusion: Factors associated with injection are likely influenced by the interaction of personal, social and larger environmental factors. In this sample, IDUs were younger, used buprenorphine, engaged in a high frequency of drug use per day, and had a previous history of cessation in prison or government camps. Interventionists must be able to tailor care of drug users based on contextual factors, such as date of drug use initiation. However, knowledge about these factors can indirectly guide us to identify and assess other contextual factors that may have an impact on the significance of risk factors for injection. In this study, the time-bound contextual conditions (before/after 2000) under which an individual initiate drug use are key factors to be considered as the first step in any risk factor evaluation for injection. For instance, the significance of some social factors, such as level of education; or personal factors, like history of rehabilitation in prison; may be relevant during a certain time period due to impact of other environmental factors, such as level of access to provided educational program about negative impact of injection at schools, or availability of drug or substance therapy services inside prison. When working with the drug-using population, we must be careful not to group them in a single category. Identifying risk factors associated with injection can help design more effective strategies for this subgroup of drug users (non-IDUs) from becoming injection drug users (IDUs). One gains the ability to target these risk factors in order to prevent injection initiation, providing harm reduction to drug users who have yet to inject and are at the highest risk for injecting.

Just say know: How the parent movement shaped America’s modern war on drugs, 1970-2000

Between 1973 and 1978, a dozen states containing over a third of the nation’s population decriminalized or legalized the possession of marijuana. Through the work of groups like the National Organization for the Reform of Marijuana Laws (NORML) and business groups catering to the growing field of marijuana consumers, pot and its surrounding culture swept the United States, with head shops opening in local malls while movies and music celebrated the drug’s use. In response to the increasing availability of marijuana, however, rates of adolescent marijuana use spiked. By 1979, 11 percent of high school seniors reported smoking pot daily. In response, a counterrevolution to marijuana’s thriving “drug culture” formed among the nation’s parents. The parent movement, founded by Marsha “Keith” Manatt Schuchard in the summer of 1976, rejected the common opinion that marijuana was harmless, and Schuchard emphasized that parents had a duty to take control of their children’s environment and prevent their family from using drugs. Schuchard’s platform, known as “parent power,” was spread through meetings, media coverage, and educational forums and conferences, and thousands of desperate parents quickly joined the fold. By 1980, the movement had spread nationwide, with local parent groups in every state using education and consciousness-raising to further their message. By the time Ronald Reagan was elected to the presidency, the National Federation of Parents for Drug-Free Youth (NFP) had formed in nearby Silver Spring, Maryland. This national umbrella group engaged in political lobbying and organizing the over four thousand individual parent groups that had sprouted across the United States. It also aligned with Nancy Reagan when the first lady took on adolescent drug abuse prevention as her national platform. By 1983, members of the parent movement were involved in directing the course of federal anti-drug education, presenting at congressional hearings, influencing national media campaigns, and determining how to use the millions of dollars in federal and private funding that the movement was regularly receiving. In the wake of these massive national anti-drug efforts, rates of adolescent marijuana use plummeted. Despite this success, however, the movement died off by the early 1990s. This dissertation is the first complete history of the parent movement, as well as an examination of its most long-lasting effects. It posits two primary arguments: that the parent movement was responsible for placing children at the center of the nation’s war on drugs, and that its history complicates the overly-simplified narrative of “America’s right turn.” It also exposes several of the hidden aspects of the movement’s history, including the important contributions of non-white activists and the role that the parent movement, drug use and anti-drug prevention played in the nation’s culture wars that took place during this time. Supported by interviews with parent activists as well as access to newsletters, correspondence and other materials, this dissertation shows how intimately connected the parent movement was to the social and political environment of its time, and how its contributions to the nation’s war on drugs continue to have deep ramifications today.

A Permanent Dragnet?: Drug Arrests, Violent Crime, and Durable Disadvantage in the Urban US

This dissertation analyzes changes in the drug arrest rates of approximately two-hundred United States cities, the largest by population in 1990, from around 1980, prior to the advent of crack cocaine and the accompanying increase in drug arrest rates, until 2008, when violent crime levels had experienced sustained and major declines in the urban US. Drug arrests are demonstrated to be an important research topic because of the contribution of drug law enforcement to record high US prison admission and incarceration rates, as well as possible disparate impacts of aggressive drug law enforcement upon poor and minority communities. The analysis focuses particularly on the changing relationship of drug arrest rates to urban violence levels and indicators of disadvantage. Also included in the dissertation are chapters analyzing the changing relationship of drug arrests to drug abuse as a public health problem, as indicated by drug-related emergency room hospitalization rates; the changing composition of drug arrest rates by race of arrestee, drug type, and seriousness (possession vs. distribution) of the offense; and changing patterns of drug usage with regard to the socioeconomic and demographic characteristics of users. Longitudinal multivariate statistical techniques, including multilevel mixed effects modeling, are used to determine the static and dynamic urban characteristics associated with trajectories of change in municipal drug arrest rates, subsequent to their mid-1990s peak period. Changes in municipal violent crime levels are also modeled, from their early-1990s peak period onward, for the purpose of comparison. The central substantive question framing the inquiry concerns better understanding the tendency of drug arrest rates to remain elevated near their peak levels, through the 1990s and 2000s, even as urban violence levels, with which drug arrest rates were once strongly associated, precipitously and sustainably declined. The dissertation analyzes the unraveling of a previously tight nexus between municipal drug arrest rates, urban violence levels, indicators of drugs as a public health problem, and contemporaneous indicators of urban disadvantage, even as drug arrest rates have remained closely connected to–and indeed become a durable aspect of–long-term patterns of disadvantage in the urban US.